Low-Normal Serum Sodium and Heart Failure-Related Events in Patients With Heart Failure With Preserved Left Ventricular Ejection Fraction

Background:Hyponatremia has been shown to be a prognostic factor in heart failure (HF) with preserved ejection fraction (HFpEF). Serum sodium (sNa) cut-off, however, is not defined in HFpEF. Therefore, we investigated the relationship between sNa and HF-related events (cardiovascular death and hospi...

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Published in:Circulation Journal 2016/01/25, Vol.80(2), pp.411-417
Main Authors: Kusaka, Hiroaki, Sugiyama, Seigo, Yamamoto, Eiichiro, Akiyama, Eiichi, Matsuzawa, Yasushi, Hirata, Yoshihiro, Fujisue, Koichiro, Kurokawa, Hirofumi, Matsubara, Junichi, Sugamura, Koichi, Maeda, Hirofumi, Jinnouchi, Hideaki, Matsui, Kunihiko, Ogawa, Hisao
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Disease-Free Survival
Echocardiography
Female
Follow-Up Studies
Heart failure
Heart Failure - blood
Heart Failure - diagnostic imaging
Heart Failure - mortality
Heart Failure - physiopathology
Heart Failure - therapy
Humans
Hyponatremia
Hyponatremia - blood
Hyponatremia - diagnostic imaging
Hyponatremia - mortality
Hyponatremia - physiopathology
Hyponatremia - therapy
Male
Middle Aged
Prognosis
Sodium
Sodium - blood
Stroke Volume
Survival Rate
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Summary:Background:Hyponatremia has been shown to be a prognostic factor in heart failure (HF) with preserved ejection fraction (HFpEF). Serum sodium (sNa) cut-off, however, is not defined in HFpEF. Therefore, we investigated the relationship between sNa and HF-related events (cardiovascular death and hospitalization for HF decompensation) in HFpEF patients.Methods and Results:We assessed cardiac function using echocardiography and measured sNa in HFpEF patients with New York Heart Association class II (n=321) or III (n=84) in a compensated condition after implementing medical therapy for HF. During a mean follow-up of 27 months, 73 patients developed HF-related events. On multivariate Cox hazard analysis including established predictors in HF, sNa level as a continuous variable was identified as an independent predictor for HF-related events in HFpEF (per 1.0 mmol/L: HR, 0.93; 95% CI: 0.87–0.98; P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-15-0878